Outbreak of tularaemia connected to a contaminated well in the Västra Götaland region in Sweden

Tularaemia, is a zoonotic disease caused by the bacterium Francisella tularensis. This disease has been reported in Sweden since 1931 and its wide distribution in the country poses a challenge for understanding the transmission, ecology and epidemiology of the disease. In Sweden, the disease is usually transmitted by mosquitoes, but in this study we could show that consumption of well water was epidemiologically linked to the outbreak, by isolating F. tularensis from the water. In this article, we describe an outbreak of tularaemia in the region of Västra Götaland in the southwest of Sweden in spring of 2013.     

Tularemia

Tularemia is a potentially fatal multi-systemic disease of humans and other animals caused by the bacterial pathogen Francisella tularensis. The disease can be transmitted by ticks, biting flies, water exposure, food, and aerosols and occurs around the northern hemisphere including North America, Europe, and Asia. There are several defined species and subspecies, including F. tularensis subsp. tularensis (Jellison Type A) which is pathogenic for rabbits and occurs in North America, F. tularensis subsp. holarctica (Type B) and mediaasiatica which are less pathogenic for rabbits, and F. tularensis subsp. novicida which has been regarded sometimes as the separate species F. novicida. Because it can have a high aerosol-related infection rate, low infectious dose, and ability to induce fatal disease, F. tularensis is considered a potential agent of biological warfare and is classified by the US Department of Health and Human Services as a List A select agent. We discuss microbiological, clinicopathological, epidemiological, and ecological aspects of tularemia.     

Hunting For Tularaemia – A Review of Cases in North Carolina

Human infections with Francisella tularensis can be acquired via numerous routes, including ingestion, inhalation, arthropod bite or direct contact with infected animals. Since 1991, there have been 25 reported cases of tularaemia in North Carolina, most of which were associated with rabbit hunting or cat bites. We present two adults cases of pulmonary and oropharyngeal tularaemia and review the reported cases since 1991–2013. We also present the fifth case of pulmonary empyema. While cavitary pneumonias are primarily treated with drainage, we illustrate a case of cavitary pneumonia associated with tularaemia successfully treated with oral ciprofloxacin after drainage. Tularaemia should be considered in patients with a perplexing radiographic image, animal exposure and lack of response to conventional empiric broad‐spectrum antibiotics. Even in serious cases of pneumonic tularaemia, fluoroquinolones may provide a suitable alternative to aminoglycosides.     

Tularemia in Alaska, 1938 - 2010

Tularemia is a serious, potentially life threatening zoonotic disease. The causative agent, Francisella tularensis, is ubiquitous in the Northern hemisphere, including Alaska, where it was first isolated from a rabbit tick (Haemophysalis leporis-palustris) in 1938. Since then, F. tularensis has been isolated from wildlife and humans throughout the state. Serologic surveys have found measurable antibodies with prevalence ranging from < 1% to 50% and 4% to 18% for selected populations of wildlife species and humans, respectively. We reviewed and summarized known literature on tularemia surveillance in Alaska and summarized the epidemiological information on human cases reported to public health officials. Additionally, available F. tularensis isolates from Alaska were analyzed using canonical SNPs and a multi-locus variable-number tandem repeats (VNTR) analysis (MLVA) system. The results show that both F. t. tularensis and F. t. holarctica are present in Alaska and that subtype A.I, the most virulent type, is responsible for most recently reported human clinical cases in the state.     

The rate of Salmonella spp. infection in zoo animals at Seoul Grand Park, Korea

Salmonellosis is an important zoonotic disease that affects both people and animals. The incidence of reptile-associated salmonellosis has increased in Western countries due to the increasing popularity of reptiles as pets. In Korea, where reptiles are not popular as pets, many zoos offer programs in which people have contact with animals, including reptiles. So, we determined the rate of Salmonella spp. infection in animals by taking anal swabs from 294 animals at Seoul Grand Park. Salmonella spp. were isolated from 14 of 46 reptiles (30.4%), 1 of 15 birds (6.7%) and 2 of 233 mammals (0.9%). These findings indicate that vigilance is required for determining the presence of zoonotic pathogen infections in zoo animals and contamination of animal facilities to prevent human infection with zoonotic diseases from zoo facilities and animal exhibitions. In addition, prevention of human infection requires proper education about personal hygiene.     

Francisella tularensis survey among ranchers and livestock in western Iran

Tularemia is a zoonotic disease that transmitted to humans and domestic animals by wildlife, especially rodents. There are some evidences of the circulation of F. tularensis in rodents, livestock, human populations, and surface waters in western parts of Iran. In this study, we investigated the exposure of livestock and ranchers to F. tularensis in the endemic regions of western Iran. Blood samples were collected from 289 sheep, 103 cattle, and 51 ranchers in 2018. Animal sera were tested by standard tube agglutination method. The specific IgGs against F. tularensis were evaluated by ELISA in human sera. Moreover, the extracted DNAs from 50 sheep spleen samples were evaluated using TaqMan real-time PCR for the presence of ISFtu2 and FopA genes. All animal sera and spleen samples were negative for tularemia. Of the 51 human samples, two samples were seropositive and one sample showed a borderline status for tularemia. Serologic evidence of F. tularensis in the ranchers but negative results in the livestock indicates different transmission routes in human populations and domestic animals in western Iran. Therefore, drinking contaminated water, contact to wildlife or rodents and arthropod bite should be considered as probable routes in the suspicious areas.     

Immunization of BALB/c mice with Brucella abortus 2308ΔwbkA confers protection against wild-type infection

Brucellosis is a zoonotic disease that causes animal and human diseases. Vaccination is a major measure for prevention of brucellosis, but it is currently not possible to distinguish vaccinated animals from those that have been naturally infected. Therefore, in this study, we constructed the Brucella (B.) abortus 2380 wbkA mutant (2308ΔwbkA) and evaluated its virulence. The survival of 2308ΔwbkA was attenuated in murine macrophage (RAW 264.7) and BALB/c mice, and it induced high protective immunity in mice. The wbkA mutant elicited an anti-Brucella-specific immunoglobulin G response and induced the secretion of gamma interferon. Antibodies to 2308ΔwbkA could be detected in sera from mice, implying the potential for use of this protein as a diagnostic antigen. The WbkA antigen would allow serological differentiation between infected and vaccinated animals. These results suggest that 2308ΔwbkA is a potential attenuated vaccine against 16M. This vaccine will be further evaluated in sheep.     

Population genetics of Toxoplasma gondii: new perspectives from parasite genotypes in wildlife

Toxoplasma gondii, a zoonotic protozoal parasite, is well-known for its global distribution and its ability to infect virtually all warm-blooded vertebrates. Nonetheless, attempts to describe the population structure of T. gondii have been primarily limited to samples isolated from humans and domesticated animals. More recent studies, however, have made efforts to characterize T. gondii isolates from a wider range of host species and geographic locales. These findings have dramatically changed our perception of the extent of genetic diversity in T. gondii and the relative roles of sexual recombination and clonal propagation in the parasite's lifecycle. In particular, identification of novel, disease-causing T. gondii strains in wildlife has raised concerns from both a conservation and public health perspective as to whether distinct domestic and sylvatic parasite gene pools exist. If so, overlap of these cycles may represent regions of high probability of disease emergence. Here, we attempt to answer these key questions by reviewing recent studies of T. gondii infections in wildlife, highlighting those which have advanced our understanding of the genetic diversity and population biology of this important zoonotic pathogen.     

Zoonotic enteric protozoa

A growing number of enteric protozoan species are considered to have zoonotic potential. Their clinical impact varies and in many cases is poorly defined. Similarly, the epidemiology of infections, particularly the role of non-human hosts, requires further study. In this review, new information on the life cycles and transmission of Giardia, Cryptosporidium, Entamoeba, Blastocystis and Balantidium are examined in the context of zoonotic potential, as well as polyparasitism and clinical significance.     

Human tularaemia associated with exposure to domestic dogs—United States, 2006–2016

Dogs have been implicated in the zoonotic transmission of numerous pathogens. Whereas cats are known to transmit Francisella tularensis to humans via bite and other routes, the role of dogs in facilitating infection is much less understood. We reviewed tularaemia case investigation records collected through national surveillance during 2006–2016 to summarize those with dog involvement, characterize the nature of dog‐related exposure and describe associated clinical characteristics. Among 1,814 human tularaemia cases, 735 (41%) supplemental case investigation records were available for review; and of those, 24 (3.3%) were classified as dog‐related. Median age of patients was 51 years (range: 1–82); 54% were female. Two thirds (67%) of cases presented with ulceroglandular/glandular tularaemia; pneumonic (13%) and oropharyngeal (13%) illness occurred less frequently. Dog‐related exposures were classified as follows: direct contact via bite, scratch or face snuggling/licking (n = 12; 50%); direct contact with dead animals retrieved by domestic dogs (n = 8; 33%); and contact with infected ticks acquired from domestic dogs (n = 4; 17%). Prevention of dog‐related tularaemia necessitates enhanced tularaemia awareness and tick avoidance among pet owners, veterinarians, health care providers and the general public.     

Old problems on a new playing field: Helminth zoonoses transmitted among dogs, wildlife, and people in a changing northern climate

Although surveillance is limited, indigenous residents at latitudes ranging from 53 to 73°N in Canada appear to have a higher occurrence of infection with some zoonotic parasites than the general population. Conversely, they are relatively naïve to other zoonotic parasites that have previously been unable to establish at northern latitudes. For those parasites that circulate among dogs, wildlife, and people, potential risk factors in the North include limited availability of veterinary services, presence of free-roaming dog populations, and consumption of locally harvested fish and wildlife. These regions are also experiencing some of the greatest impacts of climate change in North America, including increased temperature, precipitation, and frequency and severity of extreme weather. We review the current taxonomy, genetic diversity, host and geographic distributions, epidemiology and risk factors for 3 genera of helminths (Diphyllobothrium spp., Echinococcus spp., and Toxocara sp.) in Canada's North in order to identify climate-sensitive aspects of their ecology. Free-living stages of parasitic zoonoses endemic in the Arctic (such as Diphyllobothrium dendriticum, the cervid strain of Echinococcus granulosus, and Arctic strains of Echinococcus multilocularis) will experience trade-offs between enhanced survival under wetter conditions and increased mortality under warmer conditions. Climate change might also lead to the introduction and establishment in the Arctic of parasitic zoonoses previously restricted to the sub-Arctic, such as Diphyllobothrium latum, Toxocara canis, and the prairie strain of E. multilocularis. Molecular techniques applied in broad geographic surveys are needed to address critical knowledge gaps in the geographic distribution, genetic diversity, and public health significance of zoonotic helminths already in the circumpolar North, and to determine the current barriers to range expansion of temperate-adapted parasites into the North. Dogs will continue to play important roles in the North, including that of a “bridging” host between sylvatic cycles and human communities. In a warming north, increased opportunities for business, agriculture, and tourism favor importation of dogs and their parasites into a newly suitable environment. Collaborations among veterinarians, public health personnel, and policy-makers are needed to enhance surveillance and mitigate for dog-transmitted parasitic zoonoses in a changing North.     

Natural History of Ehrlichia chaffeensis: Vertebrate hosts and tick vectors from the United States and evidence for endemic transmission in other countries

Ehrlichia chaffeensis, an intracellular gram-negative zoonotic bacterium, is the causative agent of human monocytotropic ehrlichiosis (HME). In humans, the disease can range from a mild, non-specific illness with few to no clinical signs to a moderately severe to fatal disease, especially those with compromised immune systems. E. chaffeensis is maintained in a complex cycle involving white-tailed deer (WTD; Odocoileus virginianus) as a primary reservoir and the lone star tick (LST; Amblyomma americanum) as a primary vector. Numerous other species are naturally exposed to E. chaffeensis and disease has been documented in some domestic animals and wildlife including domestic dogs and ring-tailed lemurs. The organism has been found throughout the natural range of the LST and as the tick continues to expand its range, the geographic range of risk for E. chaffeensis infections will likely continue to expand. Recent data have indicated that E. chaffeensis, or a closely related organism, has been found in many species of ticks and vertebrate hosts in numerous countries.     

Fasciola hepatica in wild boar (Sus scrofa) from Italy

Fasciola hepatica is a trematode infecting ruminants worldwide, occasionally reported in a wide range of animal species, including humans. According to the WHO, fasciolosis is recognized as a re-emerging neglected tropical disease, responsible for endemic and epidemic outbreaks in humans. Although the main hosts of the parasite are represented by cattle, sheep and goats, wildlife may be involved in its circulation. Here we firstly report F. hepatica in a wild boar from Italy (southern area) and characterize it both morphologically and molecularly. The nad1 gene analysis of specimens analyzed, revealed a high genetic similarity with those of humans from Iran and Peru, as well as a close phylogenetic relationship to those in ruminants from Brazil, Ecuador and Egypt. Considering the increase in the wild boar populations in urban and peri-urban areas, a potential role of this ungulate in the circulation of this zoonotic trematode is suggested.     

Bartonella spp. in cats from Buenos Aires,Argentina

In Argentina, data on the presence of members of the genus Bartonella is scarce. To increase knowledge about these zoonotic pathogens in this country, the presence and variability of Bartonella spp. was investigated in cats and dogs from Buenos Aires. Bartonella spp. was detected in 17.8% of cats, while all dogs tested negative by PCR and Reverse Line Blot. B. henselae was the most frequent species, being detected in 11.9% (14/101), while B. clarridgeiae was found in only 5.9% (6/101) of the cats. Afterwards, B. henselae isolates and positive blood samples were characterized by Multiple Locus Sequence Typing (MLST) and Multiple Locus Variable Number Tandem Repeats Analysis (MLVA). As result, four different MLST sequence types (ST) and eight MLVA profiles were identified. ST 1 was the most frequent variant found in cats, followed by ST 8. Interestingly, some of the MLVA profiles that were detected in this study have been previously associated with human disease, and represents a potential risk of infection. Veterinarians and physicians should consider the presence of these emerging pathogens in their diagnostic routine.     

Brachyspira and its role in avian intestinal spirochaetosis

The fastidious, anaerobic spirochaete Brachyspira is capable of causing enteric disease in avian, porcine and human hosts, amongst others, with a potential for zoonotic transmission. Avian intestinal spirochaetosis (AIS), the resulting disease from colonisation of the caeca and colon of poultry by Brachyspira leads to production losses, with an estimated annual cost of circa £18 million to the commercial layer industry in the United Kingdom. Of seven known and several proposed species of Brachyspira, three are currently considered pathogenic to poultry; B. alvinipulli, B. intermedia and B. pilosicoli. Currently, AIS is primarily prevented by strict biosecurity controls and is treated using antimicrobials, including tiamulin. Other treatment strategies have been explored, including vaccination and probiotics, but such developments have been hindered by a limited understanding of the pathobiology of Brachyspira. A lack of knowledge of the metabolic capabilities and little genomic information for Brachyspira has resulted in a limited understanding of the pathobiology. In addition to an emergence of antibiotic resistance amongst Brachyspira, bans on the prophylactic use of antimicrobials in livestock are driving an urgent requirement for alternative treatment strategies for Brachyspira-related diseases, such as AIS. Advances in the molecular biology and genomics of Brachyspira heralds the potential for the development of tools for genetic manipulation to gain an improved understanding of the pathogenesis of Brachyspira.     

Retrospective Biomolecular Investigation of Coxiella burnetii and Leptospira spp. DNA in Cases of Abortion,Stillbirth and Neonatal Mortality in Dogs and Cats

Abortion and neonatal mortality are events that can occur in breeding bitches and queens. It has been reported that up to 55% and 33% of these cases remain without a known cause, respectively, in canine and feline pregnancies. Unusual abortigenic and potentially zoonotic agents, including Coxiella burnetii and Leptospira spp., may be involved in these cases. C. burnetii is able to cause reproductive disorders in cattle, sheep and goats, and cases of abortion have been observed in dogs and cats. Moreover, several outbreaks of C. burnetii infection in humans have been caused by delivering bitches and queens, and some of these animals experienced abortion. Leptospira interrogans sensu lato is able to cause abortion or stillbirth in several animal species and its abortigenic role has occasionally been described in bitches and queens. The aim of this study was to search for C. burnetii and Leptospira spp. DNA in a retrospective series of 103 cases of canine and feline abortion, stillbirth, and neonatal mortality submitted for the identification of possible infectious agents. One hundred and fifty-one specimens were tested using PCR assays and found negative for C. burnetii and Leptospira DNA. However, in 49 samples (47.6%) other infectious causes of abortion, stillbirth, and neonatal mortality were identified. These results showed that C. burnetii and Leptospira spp. are probably not common abortigenic agents or causes of neonatal deaths in dogs. However, given the potential abortigentic and zoonotic role of these agents, surveillance of canine and feline abortion, stillbirth, and neonatal mortality could be advisable for a systematic investigation of these events.     

Extraintestinal pathogenic Escherichia coli in poultry meat products on the Finnish retail market

Background

Extraintestinal pathogenic Escherichia coli bacteria (ExPEC) exist as commensals in the human intestines and can infect extraintestinal sites and cause septicemia. The transfer of ExPEC from poultry to humans and the role of poultry meat as a source of ExPEC in human disease have been discussed previously. The aim of the present study was to provide insight into the properties of ExPEC in poultry meat products on the Finnish retail market with special attention to their prevalence, virulence and phylogenetic profiles. Furthermore, the isolates were screened for possible ESBL producers and their resistance to nalidixic acid and ciprofloxacin was tested.

Methods

The presence of ExPEC in 219 marinated and non-marinated raw poultry meat products from retail shops has been analyzed. One E. coli strain per product was analyzed further for phylogenetic groups and possession of ten virulence genes associated with ExPEC bacteria (kpsMT K1, ibeA, astA, iss, irp2, papC, iucD, tsh, vat and cva/cv) using PCR methods. The E. coli strains were also screened phenotypically for the production of extended-spectrum β-lactamase (ESBL) and the susceptibility of 48 potential ExPEC isolates for nalidixic acid and ciprofloxacin was tested.

Results

E. coli was isolated from 207 (94.5%) of 219 poultry meat products. The most common phylogenetic groups were D (50.7%), A (37.7%), and B2 (7.7%). Based on virulence factor gene PCR, 23.2% of the strains were classified as ExPEC. Two ExPEC strains (1%) belonged to [O1] B2 svg+ (specific for virulent subgroup) group, which has been implicated in multiple forms of ExPEC disease. None of the ExPEC strains was resistant to ciprofloxacin or cephalosporins. One isolate (2.1%) showed resistance to nalidixic acid.

Conclusions

Potential ExPEC bacteria were found in 22% of marinated and non-marinated poultry meat products on the Finnish retail market and 0.9% were contaminated with E. coli [O1] B2 svg+ group. Marinades did not have an effect on the survival of ExPEC as strains from marinated and non-marinated meat products were equally often classified as ExPEC. Poultry meat products on the Finnish retail market may have zoonotic potential.